Pharmacogenetic testing in HIV
Adverse drug reactions are multifactorial in origin, but for some drugs in HIV, an underlying genetic component may contribute to the risk of developing toxicity. Screening for genetic markers associated with a particular side-effect may identify some individuals predisposed to toxicity. These genetic markers include HLA-B*57:01 for Abacavir.
HLA-B*57:01 polymorphism for Abacavir
HLA-B*57:01 testing is recommended to help identify patients with a lower risk of developing Abacavir hypersensitivity. Pharmacogenetic testing (PGx) in HIV may identify some individuals predisposed to toxicity and is well established especially for HLA-B*57:01 and Abacavir. However, also other factors can be important determinants of toxicity, including different environmental factors and potentially other genetic mutations.
Thus, absence of a susceptibility genotype does not rule out the development of toxicity, and clinical judgment must be exercised when considering risks vs benefit of a drug in individuals with or without these genotypes. Prescribing according to the manufacturer’s instructions should be adhered to and is not circumvented by the use of genetic testing.
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